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ForumsMASH / Liver DiseaseWhat even is MASH? My doc mentioned it and I panicked — my results so far

What even is MASH? My doc mentioned it and I panicked — my results so far

Dr.RaviCardio Fri, May 3, 2024 at 4:51 AM 10 replies 2,050 viewsPage 1 of 2
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Dr.RaviCardio
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May 3, 2024 at 4:51 AM#1

Fatty liver on an incidental scan two years ago and nobody followed it up. Now that I am losing weight I would like to know what to re-measure.

What I am after is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Tell me what I have not thought of.

48 18pete_manc_UK, anna.melb_AU, mark_tokyo and 45 others
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BethLabQueen
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May 3, 2024 at 6:23 AM#2
Dr.RaviCardio said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

Last edited: May 3, 2024 at 7:23 AM
47 17Dr.PulmRoch, maya_sedona, stefan_berlin and 44 others
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SleepDoc_PDX
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May 3, 2024 at 7:55 AM#3
BethLabQueen said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 323 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 226 dB/m (minimal steatosis) and stiffness normalized to 5.9 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

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quinn_sf
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May 3, 2024 at 9:27 AM#4
Dr.RaviCardio said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

This is my experience too, for whatever a second data point is worth.

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Dr.LeslieOBGYN
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May 3, 2024 at 6:26 PM#5

Adding the clinical framing, because it changes how the question reads.

ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase 3 ATTAIN trial. NASH resolution was achieved in ~60% of patients[1].

This is relevant to liver and MASH because survodutide's glucagon agonism specifically targets hepatic lipid metabolism — making it potentially the best-in-class agent for NASH/MAFLD comorbid with obesity.

References:
[1] Sanyal AJ, et al. N Engl J Med. 2024.
Last edited: May 4, 2024 at 12:26 AM
44 14mike_mealprep, NicoleRaleigh, james_edin and 41 others
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